Autosomal dominant polycystic kidney disease (ADPKD) is characterized by progressive formation of renal cysts which ultimately lead to a loss of renal function.
Tolvaptan (a V2R antagonist) is currently the only effective treatment for preserving renal function in ADPKD. However, side-effects such as polyuria limit its tolerability and thereby the therapeutic potential. This study will test whether co-administration with hydochlorothiazide can improve V2RA efficacy (slowing kidney function decline) and tolerability (quality of life) in ADPKD. Approximately 300 patients will be enrolled.
ADPKD diagnosis (modified Ravine criteria)
≥18 years old
eGFR > 25 mL/min/1.73m2
On stable treatment with the highest tolerated dose of V2RA for a minimum of 3 months
Known intolerance to hydrochlorothiazide
Use of any diuretic
Orthostatic hypotension complaints or blood pressure <105/65mmHg during screening visit
Uncontrolled hypertension (blood pressure >160/100mmHg)